1
|
Silvestri S, Deiro G, Sandrucci S, Comandone A, Molinaro L, Chiusa L, Fronda GR, Franchello A. Solitary pancreatic head metastasis from tibial adamantinoma: a rare indication to pancreaticoduodenectomy. J Surg Case Rep 2018; 2018:rjy012. [PMID: 29479415 PMCID: PMC5810439 DOI: 10.1093/jscr/rjy012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Accepted: 01/16/2018] [Indexed: 01/12/2023] Open
Abstract
Pancreatic metastases are rare, <2% of all pancreatic neoplasia. This is the first case of pancreatic metastasis from adamantinoma, a rare, low grade and slow growing tumor which is frequently localized in long bones. We describe a case of a 45-year-old woman presenting with increased bilirubin level. Computed tomography and ecoendoscopic ultra sonography revealed a pancreatic head mass. Fine-needle aspiration biopsy was consistent with metastatic adamantinoma. The patient was submitted to a standard pancreaticoduodenectomy. As in the case presented, standard pancreatic resections are safe and feasible options to treat non-pancreatic primary tumor improving patient’s survival and quality of life.
Collapse
Affiliation(s)
- S Silvestri
- Department of Surgery, S.Spirito Hospital, Casale Monferrato, Alessandria, Italy
| | - G Deiro
- Department of General Surgery, University of Eastern Piemont-AOU Maggiore della Carità Hospital, Novara, Italy
| | - S Sandrucci
- Department of Sarcoma and Rare Visceral Cancers Surgery, City of Health and Science-Molinette Hospital, Turin, Italy
| | - A Comandone
- Department of Oncology, Humanitas Cancer Center-Gradenigo Hospital, Turin, Italy
| | - L Molinaro
- 2nd Department of Pathological Anatomy, City of Health and Science-Molinette Hospital, Turin, Italy
| | - L Chiusa
- 2nd Department of Pathological Anatomy, City of Health and Science-Molinette Hospital, Turin, Italy
| | - G R Fronda
- Department of Surgery, Humanitas Cancer Center-Gradenigo Hospital, Turin, Italy
| | - A Franchello
- 4th Department of General Surgery, City of Health and Science-Molinette Hospital, Turin, Italy
| |
Collapse
|
2
|
Silvestri S, Franchello A, Deiro G, Galletti R, Cassine D, Campra D, Bonfanti D, De Carli L, Fop F, Fronda GR. Preoperative oral immunonutrition versus standard preoperative oral diet in well nourished patients undergoing pancreaticoduodenectomy. Int J Surg 2016; 31:93-9. [PMID: 27267949 DOI: 10.1016/j.ijsu.2016.05.071] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 05/19/2016] [Accepted: 05/29/2016] [Indexed: 01/08/2023]
Abstract
BACKGROUND Pancreaticoduodenectomy is still associated to high morbility, especially due to pancreatic surgery related and infectious complications: many risk factors have already been advocated. Aim of this study is to evaluate the role of preoperative oral immunonutrition in well nourished patients scheduled for pancreaticoduodenectomy. METHODS From February 2014 to June 2015, 54 well nourished patients undergoing pancreaticoduodenectomy were enrolled for 5 days preoperative oral immunonutrition. A series of consecutive patients submitted to the same intervention in the same department, with preoperative standard oral diet, was matched 1:1. For analysis demographic, pathological and surgical variables were considered. Mortality rate, overall postoperative morbility, pancreatic fistula, post pancreatectomy haemorrhage, delayed gastric emptying, infectious complications and length of hospital stay were described for each groups. Chi squared test, Fisher's Exact test and Student's T test were used for comparison. Differences were considered statistically significant at p < 0.05. Statistics was performed using a freeware Microsoft Excel (®) based program and SPSS v 10.00. RESULTS No statistical differences in term of mortality (2.1% in each groups) and overall morbility rate (41.6% vs 47.9%) occurred between the groups as well as for pancreatic surgery related complications. Conversely, statistical differences were found for infectious complications (22.9% vs 43.7%, p = 0.034) and length of hospital stay (18.3 ± 6.8 days vs 21.7 ± 8.3, p = 0.035) in immunonutrition group. CONCLUSION Preoperative oral immunonutrition is effective for well nourished patients scheduled for pancreaticoduodenectomy; it helps to reduce the risk of postoperative infectious complications and length of hospital stays.
Collapse
Affiliation(s)
- S Silvestri
- 4th General Surgery Department, Azienda Ospedaliera ed Universitaria, Città della Salute e della Scienza, Corso Bramante 88, 10129, Turin, Italy.
| | - A Franchello
- 4th General Surgery Department, Azienda Ospedaliera ed Universitaria, Città della Salute e della Scienza, Corso Bramante 88, 10129, Turin, Italy.
| | - G Deiro
- 4th General Surgery Department, Azienda Ospedaliera ed Universitaria, Città della Salute e della Scienza, Corso Bramante 88, 10129, Turin, Italy.
| | - R Galletti
- Dietetics and Clinical Nutrition Department, Azienda Ospedaliera ed Universitaria, Città della Salute e della Scienza, Corso Bramante 88, 10129, Turin, Italy.
| | - D Cassine
- 4th General Surgery Department, Azienda Ospedaliera ed Universitaria, Città della Salute e della Scienza, Corso Bramante 88, 10129, Turin, Italy.
| | - D Campra
- 4th General Surgery Department, Azienda Ospedaliera ed Universitaria, Città della Salute e della Scienza, Corso Bramante 88, 10129, Turin, Italy.
| | - D Bonfanti
- Dietetics and Clinical Nutrition Department, Azienda Ospedaliera ed Universitaria, Città della Salute e della Scienza, Corso Bramante 88, 10129, Turin, Italy.
| | - L De Carli
- Dietetics and Clinical Nutrition Department, Azienda Ospedaliera ed Universitaria, Città della Salute e della Scienza, Corso Bramante 88, 10129, Turin, Italy.
| | - F Fop
- Kidney Transplantation Department, Azienda Ospedaliera ed Universitaria, Città della Salute e della Scienza, Corso Bramante 88, 10129, Turin, Italy.
| | - G R Fronda
- 4th General Surgery Department, Azienda Ospedaliera ed Universitaria, Città della Salute e della Scienza, Corso Bramante 88, 10129, Turin, Italy.
| |
Collapse
|
3
|
Silvestri S, Franchello A, Gonella F, Deiro G, Campra D, Cassine D, Fiore A, Ostuni E, Garino M, Resegotti A, Farina EC, Fronda GR. Role of TachoSil® in distal pancreatectomy: a single center experience. MINERVA CHIR 2015; 70:175-180. [PMID: 25960031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
AIM Distal pancreatectomies (DP) are associated with high risk of postoperative complications, and in many series higher morbidity rate than duodenopancreatectomies has been reported. To evaluate the role of a collagen sponge with human fibrinogen and thrombin film (TachoSil®) in limiting the incidence of complications after DP. METHODS From 1996 to 2013, 221 patients have been submitted to distal pancreatectomy (± splenectomy) in our Division. A retrospective analysis has been conducted in a group of 36 consecutive and prospectively collected DP treated with intraoperative placement of TachoSil® on pancreatic stump from 2010 to 2013 (group 1). A control series of 36 consecutive patients (group 2) was matched 1:1 from hystorical database. The variables considered in the analysis were: age, gender, ASA score, pancreatic texture (hard vs. soft), histology, operative time, postoperative mortality, morbility (postoperative pancreatic fistula - POPF, postoperative hemorrage - PPH, delayed gastric emptying - DGE) and hospital stay. Differences between POPF, PPH, DGE and hospital stays between grops were investigated with χ² and t-Student test. Univariate analysis was conducted to determine factors related to POPF development. Statistical analysis was performed using freeware Microsoft Excel based program. RESULTS Post operative mortality was 0% in both groups. POPF were registered in 36.1% (13/36) and 41.6 % (15/36) in groups 1 and 2, respectively (P=n.s.); in group 1 we didn't observe grade C POPF, while 4 patients in control group developed grade C POPF (P<0,05). No differences were found between two groups in terms of incidence of PPH and DGE. The median duration of postoperative hospital stay in group 1 was 21.8 (7-189) days compared with 31.13 (9-249) days in group 2 (P<0.001). CONCLUSION The use of TachoSil® seems to be associated with lower incidence of grade C POPF but larger controlled trials are needed to surely assess the usefulness of TachoSil® in pancreatic surgery in order to reduce pancreatic specific complications and their severity.
Collapse
Affiliation(s)
- S Silvestri
- 4th General Surgery Department, A.O.U. Città della Salute e della Scienza, Turin, Italy -
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
4
|
Fronda GR, Maglione V, Campra D, Cucinelli M, Marracino M, Farina EC. [Role of EUS in a diagnostic and staging algorithm of pancreatic carcinoma: the surgeon point of view]. Minerva Med 2007; 98:351-356. [PMID: 17921949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Survival of pancreatic cancer is improved by surgery and is related to R0 resection. An accurate diagnosis and a careful staging are mandatory. Differential diagnosis must be estabilished between the different pancreatic lesions as carcinoma, chronic pancreatitis, cystic or endocrine neoplasms. Endoscopic ultrasound (EUS) is the best technique for diagnosis and allows cytological examination by fine needle aspiration (FNA). Preoperative resectability is defined by EUS in borderline tumors. EUS is a useful procedure for the surgical strategy of pancreatic cancer.
Collapse
Affiliation(s)
- G R Fronda
- S.C.D.O. Chirurgia Generale 7, ASO San Giovanni Battista di Torino (Molinette), Torino, Italy
| | | | | | | | | | | |
Collapse
|
5
|
De Paolis P, Mazza L, Maglione V, Fronda GR. Laparoscopic repair of Morgagni hernia and cholecystectomy in a 40-year-old male with Down's sindrome. Report of a case. MINERVA CHIR 2007; 62:197-200. [PMID: 17519846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Morgagni-Larrey hernia (MH) is an unusual diaphragmatic hernia of the retrosternal region. Few cases of MH, treated laparoscopically, associated with Down's syndrome (DS) have been reported in literature. On October 2004, a DS 40-year-old male was admitted to our Department with mild abdominal pain and nausea. Hematochemical tests were within the normal range. Ultrasonography showed biliary sludge and multiple gallstones. Chest X-ray revealed a right-sided paracardiac mass that appeared as MH after a thoraco-abdominal computed tomography (CT). Four trocars were placed as a routinary cholecystectomy. Abdominal exploration confirmed the presence of a voluminous hernia through a wide diaphragmatic defect (12 cm) on the left side of the falciform ligament, containing the last 20 cm ileal loops and right colon with the third lateral of transverse. After retrograde cholecystectomy and reduction of the herniated ileo-colonic tract from multiple adherences, the defect was repaired with an interrupted 2/0 silk suture and then a running 2/0 polypropylene suture. Postoperative course was complicated by pulmonary edema but subsequently the patient was discharged without further complications and has no recurrence after 2 years. In conclusion, surgery is necessary for symptomatic MH and to prevent possible severe complications. We preferred laparoscopy for the reduced morbidity compared to laparotomy, even if in our case the postoperative course was not uneventful. There are still few comparative data about the modality of closure of the defect between primary repair with nonabsorbable suture material, in case of small defects, or continuous monofilament suture or prosthesis in case of large defects.
Collapse
Affiliation(s)
- P De Paolis
- Department of Surgery, San Giovanni Battista Hospital, Molinette, Turin, Italy
| | | | | | | |
Collapse
|
6
|
Bertotti E, Campra D, Farina E, Longhin R, Fronda GR. [Surgical timing of pathologies if known prior to the operation. The viewpoint of the abdominal surgeon]. MINERVA CHIR 2003; 58:849-52. [PMID: 14663416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Affiliation(s)
- E Bertotti
- Azienda Ospedaliera S. Giovanni Battista, Torino, UOA di Chirurgia Generale 7, Italy
| | | | | | | | | |
Collapse
|
7
|
Leone N, De Paolis P, Garino M, Brunello F, Carrera M, Pellicano R, Fronda GR, Bumma C, Rizzetto M. Surgery for carcinoma of the gallbladder. Our experience. Panminerva Med 2002; 44:227-31. [PMID: 12094137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
BACKGROUND Carcinoma of the gallbladder is a gastrointestinal malignancy with a very poor prognosis. The 5-year survival rate amounts to less than 5% in most series. In this study we reviewed the results of surgical treatment for gallbladder carcinoma with special reference to extended radical procedures. METHODS Between 1995 and 2000 we enrolled 36 patients (17 males and 19 females), 24 of whom were treated with simple cholecystectomy and 12 with radical resection (partial hepatectomy, regional lymphadenectomy, and common bile duct resection). The tumours were classified by stage using the criteria of the American Joint Committee on Cancer (AJCC). Stages, operative procedures, results of pathologic examinations and the outcome of the resected cases were reviewed. RESULTS There were 2 postoperative deaths (0.55%). The mean follow-up period was 19.1 months (range 1-60). For stage I and II disease extended cholecystectomy had a better result than simple cholecystectomy: the 5-year survival rates were 38.4 versus 19%, respectively. For the patients with advanced stage III or IV gallbladder carcinoma, a significant advantage of survival resulted in case of liver resection as compared to surgical treatment without liver resection: the 5-year survival rates were 20 and 0%, respectively. CONCLUSIONS The survival of stage I-II patients was good. For the patients in higher stages the prognosis was significantly worse. In these cases more aggressive surgery may be needed.
Collapse
Affiliation(s)
- N Leone
- Department of Gastroenterology, Ospedale S. Giovanni Battista, Turin, Italy.
| | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Fronda GR, Garino M, Bertotti E, Marchigiano E, Avagnina G. [Gastric cancer. New frontiers in surgical therapy]. MINERVA GASTROENTERO 2002; 48:195-8. [PMID: 16489315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
The authors compare their experience in the surgical treatment of gastric carcinoma with the literature and point out that therapeutic value of a wide gastric resection and adequate lymphadenectomy can improve a 5-year survival without increasing mortality and morbidity. In an 8-year experience in 258 patients with gastric carcinoma, 249 underwent operation, 139 with curative intention. Wide gastric resection proved to be effective and safer than elective total gastrectomy, and D2-lymphadenectomy showed the same morbidity of D1 and seems to offer a better 5-year survival. Extended resections for gastric cancer, that result in simultaneous pancreatectomy, splenectomy, hesophagectomy, resection of the colon and hepatectomy, do not show significant improvement of the survival.
Collapse
Affiliation(s)
- G R Fronda
- Ospedale S. Giovanni Battista--Torino, UOA Chirurgia Generale
| | | | | | | | | |
Collapse
|
9
|
Abstract
BACKGROUND/AIMS Laparoscopic cholecystectomy has become the procedure of choice for symptomatic cholelithiasis. A study to evaluate the benefits and risks of laparoscopic cholecystectomy in cirrhotic patients was performed. METHODS Between January 1994 and December 2000, 1,100 laparoscopic cholecystectomies for symptomatic gallbladder diseases were performed. There were 24 cirrhotic patients (group A) and 72 age- and sex-matched controls (group B). All patients had well-compensated cirrhosis (Child's class A or B). RESULTS There was no operative mortality in either group and the postoperative complication rates were 20.8 and 9.72% in groups A and B, respectively (p < 0.000001). Operative time in group A was 89.16 vs. 68.41 min in group B (p < 0.000001). The estimated intraoperative blood loss in group A was 106.25 vs. 37.08 ml in group B (p < 0.000001). The average transfusion requirement was 0.155 and 0.0 units in groups A and B, respectively (p < 0.025). The hospital stay in groups A and B was 4.7 and 3.61 days, respectively (p < 0.0500). CONCLUSION Laparoscopic cholecystectomy in patients with compensated cirrhosis is safe and should be the treatment of choice for these patients. Laparotomy should be applied only if the surgeon considers the operation inadequate to be continued laparoscopically.
Collapse
Affiliation(s)
- N Leone
- Department of Gastroenterology, Molinette Hospital, Turin, Italy.
| | | | | | | | | | | |
Collapse
|
10
|
De Paolis P, Marchigiano E, Carrera M, Leone N, Pellicano R, Fronda GR. [Management of sepsis of the biliary tract: indications to surgical treatment]. MINERVA GASTROENTERO 2002; 48:37-43. [PMID: 18250622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Sepsis of the biliary tract is a severe disease, due to its course and its significant association with relevant diseases, either benign or malignant, of the biliary tract, pancreas, hepatic hilus. In many cases it remains difficult to set the limit between medical therapy, percutaneous or endoscopic therapy and surgical treatment. Through a thorough review of the last 20 years' literature, we have studied this topic and classified cholangitis according to its etiology: Iithiasis, benign stenosis or Klatskin tumor as malignant diseases. The sequential approach, endoscopy-surgery, seems to provide the best results in lithiasic cholangitis. In patients with benign stenosis of the biliary tract, a percutaneous drainage is indicated as a first choice, meanwhile surgery is limited to unsuccessful bilioplasty and to segmental extrahepatic localization of sclerosing cholangitis. On the contrary, in Klatskin tumours preoperative percutaneous drainages are useful to obtain an accurate map, which is indispensable to perform an aggressive radical hepatic resection.
Collapse
Affiliation(s)
- P De Paolis
- Azienda Ospedaliera S. Giovanni Battista - Tornio
| | | | | | | | | | | |
Collapse
|
11
|
Leone N, Debernardi-Venon W, Marzano A, Garino M, DePaolis P, Grosso M, Fronda GR, Rizzetto M. Portal hypertensive colopathy and hemorrhoids in cirrhotic patients. J Hepatol 2000; 33:1026-7. [PMID: 11131443 DOI: 10.1016/s0168-8278(00)80144-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
|
12
|
Leone N, De Paolis P, Carrera M, Pellicano R, Actis GC, Fronda GR, Rizzetto M. Management strategies in resection for carcinoma of the hepatic duct confluence: how to increase the resectability rate. Our experience and literature review. Panminerva Med 2000; 42:287-91. [PMID: 11294093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
The resectability rate of hilar bile duct carcinoma is reported to be variable and to inversely correlate with the size of the associated liver resection. In an attempt to reduce the risk of postoperative liver failure, the induction of a hypertrophy of remnant liver by preoperative portal vein embolization (PVE) has been proposed. We hereby analyse the results and the technical aspects of this procedure along with our personal experience.
Collapse
Affiliation(s)
- N Leone
- Dipartimento di Gastroenterologia Ospedale Molinette, Corso Bramante 88, 10126 Torino, Italy
| | | | | | | | | | | | | |
Collapse
|
13
|
Leone N, Volpes R, Carrera M, Pellicano R, De Paolis P, Fiorentino M, Fronda GR, Rizzetto M. Hepatocellular carcinoma in a non-cirrhotic liver. Two case reports and literature review. Panminerva Med 2000; 42:151-4. [PMID: 10965777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Hepatocellular carcinoma (HCC) is closely associated with cirrhosis, but it also develops, although much less frequently, in a non-cirrhotic liver. It is suspected that hepatocellular carcinoma has a different etiology when associated and not associated with chronic liver disease. We report two cases of patients with hepatocellular carcinoma that developed in a non-cirrhotic liver. In the first case we describe an incidental liver nodular lesion containing multiple foci of HCC including pseudogland or trabecular formation and areas of sclerosis. The non-cancerous parenchyma of the liver was histologically unremarkable except for mild fatty changes of hepatocytes and minimal dysplasia. The second case describes a combined hepatocellular carcinoma and cholangiocellular carcinoma (CCC) (mixed carcinoma) in a patient who was serologically negative for both hepatitis B and C viruses. The adjacent liver parenchyma showed mild piecemeal necrosis and mild lobular activity compatible with chronic viral hepatitis, but cirrhosis was not established. This case appears to indicate that mixed type carcinoma can develop in a non-cirrhotic liver, with CCC being far more dominant than HCC; such a finding is extremely unusual, based on previously published reports.
Collapse
Affiliation(s)
- N Leone
- Department of Gastroenterology, B Surgery, Molinette Hospital, Turin, Italy
| | | | | | | | | | | | | | | |
Collapse
|
14
|
Fronda GR, Resegotti A, Astegiano M, Farina EC, Patelli E, Giustetto A, De Paolis P. [Intestinal fistulas in Crohn disease]. MINERVA CHIR 2000; 55:431-5. [PMID: 11059237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
BACKGROUND Only a part of patients suffering from Crohn's disease has enteric fistulae and a different behaviour of Crohn's disease with fistulae is reported in the literature. Aim of this paper is to evaluate if enteric fistulae are a factor conditioning mortality, morbidity and overall postoperative course, in patients with Crohn's disease. METHODS Data on the postoperative course of 126 laparotomies for Crohn's disease, performed between November 1993 and July 1998, have been prospectively examined. Moreover, the presence of enteric fistula has been evaluated during surgery. RESULTS Out of 126 interventions, in 58 (46%) enteric fistulae were present. Mortality (5.2% vs 0), morbidity (14.5% vs 7.3%), necessity for a temporary ostomy (20.4% vs 3.5%) were greater in those patients with fistula, as compared as those without fistula. CONCLUSIONS In conclusion, it is suggested that Crohn's disease with fistulae is a different type of disease, with higher mortality and morbidity rates.
Collapse
Affiliation(s)
- G R Fronda
- Dipartimento Medico Chirurgico, Azienda Ospedaliera S. Giovanni Battista, Torino
| | | | | | | | | | | | | |
Collapse
|
15
|
Abstract
OBJECTIVE Selected mechanisms of the immune system participate in the development of inflammatory bowel disease. Recently, overexpression of the ligand for CD40 (CD40L), a lymphocyte costimulatory molecule, was shown to induce severe inflammatory bowel disease in transgenic mice. In the present study, we examined the expression of CD40 and CD40L on surgical specimens of ileum from 12 patients with Crohn's disease and 10 patients with diverticulitis. METHODS Several CD40L+ cells were present in the affected tissue of patients with Crohn's disease, whereas few scattered CD40L+ cells were detected in sections of histologically normal ileum, resected distantly from the affected tissue, in patients with diverticulitis and in normal ileum portions obtained from colorectal cancer undergoing extensive surgery. The phenotype of CD40L+ cells was mainly CD4+. RESULTS In patients with Crohn's disease, several CD40+ cells were detectable in the same areas of lymphocytes expressing CD40L, whereas in patients with diverticulitis, the number of CD40+ cells was significantly lower. Most of the CD40+ cells costained with CD20, thus showing to be B-lymphocytes, and only a few were CD14+ macrophages. Several von Willebrand-positive vessels were also positive for CD40. In addition, several infiltrating macrophages were found to express B7-1 and B7-2 molecules, the ligands of CD28 and CTLA-4, which cooperate with the CD40-CD40L pathway in lymphocyte activation. Staining of ileal lesions with anti-CTLA-4 antibodies resulted in detection of none or very few positive cells. In contrast, in patients with diverticulitis, an enhanced number of B7-1 and B7-2 and CTLA-4 was observed. CONCLUSION The local accumulation of CD40L+ together with CD40+ cells within intestinal lesions of Crohn's disease suggests the involvement of this co-stimulatory pathway.
Collapse
MESH Headings
- Abatacept
- Adult
- Antigens, CD/analysis
- Antigens, CD/genetics
- Antigens, CD20/analysis
- Antigens, Differentiation/analysis
- Antigens, Differentiation/genetics
- Antigens, Differentiation, T-Lymphocyte/analysis
- Antigens, Differentiation, T-Lymphocyte/genetics
- B-Lymphocytes/immunology
- B7-1 Antigen/analysis
- B7-1 Antigen/genetics
- B7-2 Antigen
- CD28 Antigens/analysis
- CD28 Antigens/genetics
- CD4 Antigens/genetics
- CD4-Positive T-Lymphocytes/immunology
- CD40 Antigens/analysis
- CD40 Antigens/genetics
- CD40 Ligand
- CTLA-4 Antigen
- Crohn Disease/genetics
- Crohn Disease/immunology
- Crohn Disease/pathology
- Diverticulitis, Colonic/genetics
- Diverticulitis, Colonic/immunology
- Diverticulitis, Colonic/pathology
- Female
- Gene Expression Regulation
- Humans
- Ileal Diseases/genetics
- Ileal Diseases/immunology
- Ileal Diseases/pathology
- Ileum/immunology
- Ileum/metabolism
- Immunoconjugates
- Immunoglobulin Fc Fragments/analysis
- Immunoglobulin Fc Fragments/genetics
- Ligands
- Lipopolysaccharide Receptors/analysis
- Lymphocyte Activation/genetics
- Lymphocyte Activation/immunology
- Macrophages/immunology
- Male
- Membrane Glycoproteins/analysis
- Membrane Glycoproteins/genetics
- Phenotype
- Tumor Necrosis Factor-alpha/analysis
- Tumor Necrosis Factor-alpha/genetics
- von Willebrand Factor/analysis
- von Willebrand Factor/genetics
Collapse
Affiliation(s)
- E Battaglia
- Cattedra di Nefrologia, Dipartimento di Medicina Interna, Università di Torino, Italy
| | | | | | | | | | | |
Collapse
|
16
|
Leone N, Debernardi-Venon W, Marzano A, De Paolis P, Fronda GR, Rizzetto M. [Lipohyperplasia or intestinal lipomatosis]. MINERVA GASTROENTERO 1998; 44:207-10. [PMID: 16495906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Lipohyperplasia or intestinal lipomatosis is an infrequent disease characterised by anomalous infiltration of adipose tissue in the intestinal submucosa. Localised forms are generally asymptomatic, whereas diffuse forms may lead to intestinal subocclusion, digestive hemorrhage or diarrhoea. Although benign, the differential diagnosis of intestinal lipomatosis with malignant pathologies of the colon or appendix often prompts the need for surgical exploration and the histological analysis of biopsy material. Surgical exeresis of the lesion is generally associated with the normalisation of clinical symptoms. The authors report the onset and clinical evolution of two cases of intestinal lipomatosis referred to their attention.
Collapse
Affiliation(s)
- N Leone
- Dipartimento di Gastroenterologia ed Endoscopia Digestiva, Ospedale Molinette, Turin
| | | | | | | | | | | |
Collapse
|
17
|
Toppino M, Campra D, Maramotti M, Regge D, Fronda GR, Recchia S. [Groove pancreatitis. A case report of chronic focal pancreatitis]. MINERVA GASTROENTERO 1995; 41:181-5. [PMID: 7647141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The "groove pancreatitis" is a special form of segmental chronic pancreatitis affecting the "groove" between pancreatic head, duodenum and common bile duct. This type of chronic pancreatitis was first described in 1973 and only few cases have been reported in literature. Unlike other forms of chronic pancreatitis, this is often preceded by peptic ulcers, gastric resections or biliary tract diseases; it could be associated with cysts of the duodenal wall and pancreatic cysts. Abdominal pain, vomiting due to duodenal stenosis, obstructive jaundice and weight loss are the most common presenting symptoms. The radiological features show a pancreatic mass similar to a pancreatic head carcinoma and the discrimination of groove pancreatitis from pancreatic carcinoma is often difficult or even impossible in some patients. We describe a case of groove pancreatitis treated with pancreatoduodenectomy, reviewing the clinical and radiological features. We remark that the groove pancreatitis is a disease that must be known and should be considered in the differential diagnosis of pancreatic carcinoma.
Collapse
Affiliation(s)
- M Toppino
- Istituto di Clinica Chirurgica Generale, Università degli Studi, Torino
| | | | | | | | | | | |
Collapse
|
18
|
Cattaneo U, Enrico S, Serra GC, Bergoglio D, Corno F, Fronda GR. [Refractory ascites: a fifteen-year experience with the peritoneovenous shunt]. MINERVA GASTROENTERO 1993; 39:119-26. [PMID: 8286483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The authors consider the various causes of ascites and they also develop the concept of refractory ascites. They consider the various possibilities of medical and dietary therapy whose failure constitutes the basis for a surgical approach. In the latter case it is being considered the Peritoneo Venous Shunt (PVS) that employs different types of valves. In the light of their personal experience, matured over a period of 15 years, in which 75 valves were positioned in 64 patients and precisely: 55 valves of Le Veen, 15 Hakim and 5 Denver, it is emphasized that the best results, as for as mortality and morbidity goes, were obtained through careful attention in the preoperative stage and during surgery itself with the privileged use of a Le Veen's valve. For such motives, since in a high percentage of these patients there persists a poor prognosis a year away from the onset of refractory ascites, a PVS seems proposable anyway and even though this will not alter the pathological outcome, there's a clear improvement in the quality of life without precluding any other surgical approach. Finally, the authors outline the possibilities offered by the Transjugular Intrahepatic Portosystemic Shunt (TIPS), as a new original approach for the resolution of refractory ascites.
Collapse
Affiliation(s)
- U Cattaneo
- Istituto di Clinica Chirurgica Generale e Terapia Chirurgica, Università degli Studi di Torino
| | | | | | | | | | | |
Collapse
|
19
|
Righi D, Fonio P, Fronda GR, Gandini G, Lequio L, Maass J, Maisano U, Recchia S, Zanon E. [Percutaneous treatment of bile duct lithiasis. Personal experience in the first 150 cases]. Radiol Med 1992; 83:526-34. [PMID: 1631327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Since 1983 we have percutaneously treated 150 cases of bile duct lithiasis in which previous endoscopic maneuvers had been incomplete or unfeasible. Complete resolution of lithiasis was obtained in 139 of 150 patients. In 6 cases only partial success was obtained but symptoms subsided. In 2 cases the treatment failed and the patients underwent surgery. Minor complications were observed in 12.6% of patients and resolved either spontaneously or by percutaneous maneuvers. Mortality rate was 2%. After a follow-up period of 6-12 months, 9 patients had a recurrence, completely resolved with further percutaneous treatment. These cases never required surgery. We obtained the best results in patients with stones residual after cholecystectomy or a iatrogenic stricture of the biliary tree. We obtained good results in massive lithiasis with combined endoscopic, surgical and radiological procedures. Morbidity and mortality rates were lower than in surgical series and similar to the endoscopic ones. The short hospitalization, the low cost and the possibility of treatment on an outpatient basis should promote the spreading of percutaneous techniques in the treatment of bile duct lithiasis.
Collapse
Affiliation(s)
- D Righi
- Istituto di Radiologia dell'Università, Torino
| | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Morino F, Toppino M, Fronda GR. [Severe obesity: 20 years of surgical experience]. MINERVA GASTROENTERO 1991; 37:239-51. [PMID: 1805976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- F Morino
- Istituto di Clinica Chirurgica Generale e Terapia Chirurgica, Università degli Studi di Torino
| | | | | |
Collapse
|
21
|
Cattaneo U, Andreone D, Enrico S, Serra GC, Toppino M, Corno F, Scorza V, Rovere V, Fronda GR. [Rhabdomyosarcoma. Presentation of a case with abdominal localization]. MINERVA CHIR 1991; 46:417-20. [PMID: 1714556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The Authors report a case of rhabdomyosarcoma observed in a 17-year-old boy. They emphasize that this rare form has an extremely rapid evolution, and in this case was also in an unusual site and of abnormal size. The difficulty of an early diagnosis and the impossibility of radical surgery are also underlined.
Collapse
Affiliation(s)
- U Cattaneo
- Istituto di Clinica Chirurgica Generale e Terapia Chirurgica, Università di Torino
| | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Toppino M, Capozzi MP, Tini E, Scorza V, Enrico S, Fronda GR. [Internal pancreatic fistulae. The authors' experience]. MINERVA CHIR 1991; 46:305-9. [PMID: 1866037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The paper describes the authors' personal experience of internal pancreatic fistulas. This is an uncommon pathology which should however be taken into account in the presence of ascites or pleural effusion without a clear cause. Essential diagnostic tests are chemical and physical examination and the assay of amylase in ascitic or pleural fluids. Medical treatment is sometimes efficient leading to the disappearance of the fistula. If medical therapy fails, surgery is necessary, based on pancreatic resection or the drainage of the cyst or interrupted pancreatic duct.
Collapse
Affiliation(s)
- M Toppino
- Istituto di Clinica Chirurgica Generale e Terapia Chirurgica, Università degli Studi di Torino
| | | | | | | | | | | |
Collapse
|
23
|
Fronda GR, Capozzi MP, Campra D, Recchia S. [Role of surgery in the multidisciplinary treatment of lithiasis of the common bile duct]. MINERVA GASTROENTERO 1991; 37:41-5. [PMID: 1873329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The efficacy of surgery was evaluated in 32 patients with common bile duct stones. Twenty-two patients have not undergone a previous cholecystectomy. In 13 cases an endoscopic approach was attempted before surgery. In 13 patients biliary-intestinal anastomoses were performed for large stones or bile duct strictures. In 19 cases common bile exploration with biliary drainage insertion was performed for uncomplicated biliary stones. We had no mortality and morbidity was 9%. We conclude that surgery is the treatment of choice in patients with gallbladder in situ or in cases of endoscopic failure. Endoscopic sphincterectomy may be preferred in poor-risk patients.
Collapse
Affiliation(s)
- G R Fronda
- Istituto di Clinica Chirurgica Generale e Terapia Chirurgica, Università degli Studi di Torino
| | | | | | | |
Collapse
|
24
|
Righi D, Martina MC, Tola E, Fonio P, Fronda GR, Gandini G. [Percutaneous transhepatic bilioplasty: long-term results]. Radiol Med 1990; 80:492-500. [PMID: 2244038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
We report the results of a long-term follow-up of 40/101 patients with benign biliary strictures treated with percutaneous balloon dilatation (PBD) at the Radiology Department of the University of Turin, from March 1983 to March 1990. We excluded all the patients who were not followed or treated after June 1988, being their follow-up shorter than 18 months. All patients underwent accurate clinical, biological (AST, ALT, gammaGT, alcaline phosphatase) and US controls. Mean follow-up was 33.5 months. Mean success rate was 75% in strictures of bilioenteric anastomosis, 86% in iatrogenic strictures of the common bile duct, 65% in sclerosing cholangitis, 80% in papillary strictures in which endoscopic treatment had not been possible for anatomical reasons. Our results, compared to the most important radiological and surgical series, show PBD to have lower morbidity than surgery and no mortality during the so-called peroperative period (30 days). Moreover, in case of recurrences, PBD can be repeated without further complications and does not affect eventual surgery.
Collapse
Affiliation(s)
- D Righi
- Istituto di Radiologia, Università, Torino
| | | | | | | | | | | |
Collapse
|
25
|
Abstract
Since 1983 we have performed percutaneous treatment of biliary lithiasis in 97 patients. Previous retrograde endoscopic procedures were incomplete or infeasible in all patients. Immediate results were excellent resulting in complete resolution of lithiasis in 89 of 97 patients (92%). In 4 patients (4%) partial success was obtained (symptoms subsided although there were nonobstructing residual stones). Percutaneous treatment failed in 1 patient (1%). Three patients died. Complications occurred in 14 of 97 patients (14%) and mortality at 30 days was 3%. Long-term results were evaluated in 71 patients who had a least a 6-month follow-up (mean 31 months and range 6-78 months). Eight of 71 patients (11%) had recurrence of stones and 7 of these were successfully retreated transhepatically. Percutaneous removal of biliary stones is efficacious because it has a high cure rate, a low complication rate, and a mortality rate that compares favorably to that of surgery even though the patients are usually older and in poorer general condition.
Collapse
Affiliation(s)
- G Gandini
- Istituto di Radiologia dell'Università di Torino, Italy
| | | | | | | | | | | |
Collapse
|
26
|
Serra GC, Capozzi MP, Toppino M, Enrico S, Tini E, Rovere V, Rizzi G, Scorza V, Fronda GR. [Carcinoma of the parathyroid glands. Apropos of a case associated with thyroid struma]. MINERVA CHIR 1990; 45:903-6. [PMID: 2250789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The paper reports a case of carcinoma of the parathyroid associated with thyroid struma and underlines the difficulties of intraoperative diagnosis and the surgical approach which should be adopted on the basis of this finding. Often the diagnosis of the malignant nature of the neoplasia is based on the possible appearance of local or distant recurrence rather than histological examination.
Collapse
Affiliation(s)
- G C Serra
- Istituto di Clinica Chirurgica Generale, Università degli Studi di Torino
| | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Fronda GR, Calgaro M, Toppino M, Serra GC, Cattaneo U, Garrone C, Petrini A, Contino FV. [Insular carcinoma of the thyroid gland. Observation of a clinical case]. MINERVA CHIR 1990; 45:409-13. [PMID: 2348921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
We present a case report about a patient affected by an "insular" thyroid carcinoma, a poorly differentiated carcinoma, situated morphologically and biologically in an intermediate position between the well-differentiated (papillary and follicular) and the totally undifferentiated thyroid tumors. We believe that its separation from other types of thyroid cancer will lead to a more accurate estimate of its prognosis and a more aggressive therapeutic approach.
Collapse
Affiliation(s)
- G R Fronda
- Istituto di Clinica Chirurgica Generale e Terapia Chirurgica, Università degli Studi di Torino
| | | | | | | | | | | | | | | |
Collapse
|
28
|
Festa V, Simone P, Enrico S, Garrone C, Lisa F, Fronda GR. [Carcinoma of the gallbladder. Our experience]. MINERVA CHIR 1989; 44:1229-33. [PMID: 2761724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
A series of 14 patients (6 males and 8 females) suffering from gallbladder cancer has been examined. Postoperative mortality, mean survival, quality of life understood as time free from symptomatology, and the incidence of early postoperative complications in relation to the various types of radical and palliative intervention performed were evaluated.
Collapse
|
29
|
Morino F, Robecchi A, Fronda GR, Piemontesi F, Morino M. [Prosthesis in surgery of portal hypertension]. MINERVA CHIR 1989; 44:477-9. [PMID: 2717028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
|
30
|
Fronda GR, Toppino M, Capozzi MP, Morino M, Scollo MA, Recchia S. [A rare complication in the suppression of a porto-systemic shunt in disabling encephalopathy]. Chir Ital 1988; 40:369-76. [PMID: 3267475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The authors describe an uncommon complication in a case of side-to-side portacaval shunt which was suppressed due to disabling portal-systemic encephalopathy; the patient was treated by esophageal transection with esophagogastric devascularization and nonoperative secondary occlusion of the shunt by external elastic traction on a Silastic catheter surrounding the anastomosis: a stenosis of the caval vein under traction required another operation in order to close the shunt.
Collapse
Affiliation(s)
- G R Fronda
- Università degli Studi di Torino, Istituto di Clinica Chirurgica Generale e Terapia Chirurgica
| | | | | | | | | | | |
Collapse
|
31
|
Cesarani F, Gandini G, Righi D, Juliani E, Recchia S, Fronda GR. [Use of a high-frequency pulsed hydro jet in the percutaneous treatment of biliary tract calculi]. Radiol Med 1988; 76:453-7. [PMID: 3205922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
A new system (Broxo Jet) is described for bile duct washing to complete mechanical maneuvers during nonsurgical treatment of intra- and extrahepatic calculi. The device is connected either to a percutaneous biliary drainage catheter or to a fibroscope, and provides a high-frequency pulsating water jet. Seven patients with intra- and extrahepatic bile duct stones were treated with this new technique. Complete resolution was observed in 4/7 cases. The water jet allows the mobilization of even the biggest stones and the elimination of stone debris, as well as the removing of fibrin and necrotic tissue fragments tightly attached to bile duct walls in subacute cholangitis.
Collapse
Affiliation(s)
- F Cesarani
- Istituto di Radiologia, Università Torino
| | | | | | | | | | | |
Collapse
|
32
|
Fronda GR, Morino M, Sacco D, Tapparo A, Tini E, Toppino M, Cattaneo U. [Surgical treatment of chronic pancreatitis. Our personal experience]. MINERVA CHIR 1988; 43:1677-81. [PMID: 3231314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
|
33
|
Toppino M, Fronda GR, Scollo MA, Corno F, Capozzi MP, Tapparo A. [Multiple jejunal metastases of a melanoma. Description of a clinical case]. MINERVA CHIR 1988; 43:1643-8. [PMID: 2466223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
|
34
|
Righi D, Asnaghi R, Cesarani F, Juliani E, Vaudano G, Cavalot G, Fronda GR, Gandini G. [Internal transhepatic biliary drainage in the treatment of neoplastic obstructive jaundice. Long-term results in 70 cases]. MINERVA CHIR 1988; 43:1417-24. [PMID: 2465505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
|
35
|
Morino F, Fronda GR, Cattaneo U, Morino M, Calgaro M. [Reinterventions in bilio-digestive anastomosis]. G Chir 1988; 9:614-21. [PMID: 3155232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
|
36
|
Robecchi A, Fronda GR, Scollo MA, Toppino M, Cattaneo U, Capozzi MP, Calgaro M, Corno F, Passarelli E. [Leiomyosarcoma of the duodenum. Description of a clinical case]. MINERVA CHIR 1988; 43:771-6. [PMID: 3050607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
|
37
|
Robecchi A, Fronda GR, Scollo MA, Piemontesi F, Morino M. [The surgeon's role in cholelithiasis]. MINERVA CHIR 1988; 43:471-4. [PMID: 3399102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
|
38
|
Robecchi A, Ginardi A, Scollo MA, Scaglia M, Cattaneo U, Piemontesi F, Bergoglio D, Fronda GR. [Surgery in uremic patients on chronic hemodialysis]. MINERVA CHIR 1987; 42:1889-92. [PMID: 3431717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
|
39
|
Morino F, Robecchi A, Morino M, Fronda GR, Scollo MA. [Prosthesis in portal hypertension]. MINERVA CHIR 1987; 42:359-63. [PMID: 2955250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
|
40
|
Fronda GR, Cattaneo U, Piemontesi F, Scollo MA, Bergoglio D, Robecchi A. [Hepatic hydatidosis. Observations on 35 cases]. MINERVA CHIR 1987; 42:415-20. [PMID: 3601124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
|
41
|
Cavallo-Perin P, Bruno A, Nuccio P, Dall'omo AM, Fronda GR, Avagnina P, Molino G, Bozzo C, Pagano G. Insulin resistance in human liver cirrhosis is not modified by porto-systemic surgical shunt. Acta Endocrinol (Copenh) 1986; 112:377-82. [PMID: 3529784 DOI: 10.1530/acta.0.1120377] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Cirrhosis of the liver is characterized by glucose intolerance and hyperinsulinaemia. It is considered an insulin resistant state with both a receptor and a post-receptor defect of insulin activity. It would appear that reduced hepatic degradation rather than increased B-cell production is responsible for hyperinsulinaemia. The effect of surgical portosystemic shunt on insulin resistance was studied in 18 cirrhotics with impaired glucose tolerance (12 males, 6 females; mean age 46.9 +/- 0.7 years) by measuring: glucose production (3H-glucose infusion), glucose utilisation (euglycaemic clamp at approximately 100, approximately 1000 and approximately 10,000 microU/1), plasma insulin and C-peptide levels, and liver function indices (serum bilirubin, albumin, ALT, GGT) before and 2 months after surgery. Liver sorbitol clearance was also employed to measure variations in the functional liver plasma flow induced by the shunt. No significant changes were noted in: glucose production (1.94 +/- 0.17 SEM vs 1.96 +/- 0.17 mg/kg/min), glucose utilisation (metabolic clearance rate: 3.32 +/- 0.48 vs 3.42 +/- 0.43 at approximately microU/ml; 9.70 +/- 1.0 vs 9.16 +/- 0.9 at approximately 1000 microU/ml; 10.92 +/- 1.1 vs 11.07 +/- 0.8 ml/kg/min at approximately 10 000 microU/ml), fasting plasma insulin, C-peptide and C-peptide/insulin molar ratio (4.66 +/- 0.47 vs 5.50 +/- 0.54), and the liver function indices. By contrast, there was a significant decrease in functional liver plasma flow (813 +/- 34 vs 604 +/- 34 ml/min, P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
Collapse
|
42
|
Gandini G, Asnaghi R, Cesarani F, Righi D, Fronda GR, Robecchi A. [Percutaneous correction of benign stenosis of the bile ducts and biliary-digestive anastomosis. Percutaneous transhepatic biliplasty]. Radiol Med 1985; 71:307-15. [PMID: 4059598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The authors describe their experience in nine cases of transhepatic percutaneous dilatation of bile ducts benign stenosis by a Gruntzig catheter inflated at the stenotic level in order to stretch the sclerotic lesion. Despite the brief follow-up, the first results are satisfying; for this reason percutaneous dilatation of bile ducts benign stenosis could be a new procedure in the treatment of these lesions in selected cases.
Collapse
|
43
|
Morino F, Robecchi A, Avagnina S, Cattaneo U, Gaido G, Fronda GR. [Gastric bypass in the therapy of obesity. Indications and results]. MINERVA CHIR 1984; 39:1293-7. [PMID: 6521885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
|
44
|
Defilippi C, Garretti L, Tetti C, Gandini G, Fronda GR, Serra G, Robecchi A. [Instrumental follow-up of patients treated by internal biliary drainage]. Minerva Med 1983; 74:2611-6. [PMID: 6606792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The various radiological techniques available for the long-term follow-up of patients given definitive percutaneous trans-hepatic biliary implants (DTBI) are evaluated on the basis of personal experience. After a rapid examination of the available technics it is concluded that direct X-ray, echotomography and sequential hepatobiliary scintigraphy are more than sufficient for an accurate follow-up of the disease in such patients.
Collapse
|
45
|
Morino F, Robecchi A, Porcellana V, Fronda GR, Morino M. [Surgical therapy of severe obesity: gastric by-pass]. MINERVA CHIR 1983; 38:1669-72. [PMID: 6664566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
|
46
|
Defilippi C, Garretti L, Spalluto F, Grosso M, Cattaneo U, Fronda GR, Borello M, Bonardi L. [2 cases of giant common bile duct calculi]. MINERVA CHIR 1983; 38:773-8. [PMID: 6888732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|
47
|
Morino F, Robecchi A, Fronda GR, Serra GC, Cattaneo U. [Surgical treatment of endocrine tumors of the pancreas]. Minerva Med 1982; 73:2549-54. [PMID: 6289191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Following a brief review of the literature dealing with the rarity of this disease, and the diagnostic progress made to date, the surgical techniques applicable to the various locations of the neoplasia are described. Personal experience with 8 insuloma patients is reported.
Collapse
|
48
|
Emanuelli G, Gatti G, Calcamuggi G, Anfossi G, Marcarino C, Robecchi A, Fronda GR, Garrone C. [Immunomorphological aspects of the kidney in liver cirrhosis and obstructive jaundice]. Minerva Med 1982; 73:1157-8. [PMID: 7043319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
|
49
|
Bergoglio D, Cattaneo U, Garrone C, Spidalieri G, Tallone MV, Fronda GR. [Septic complications in subclavian vein catheterization]. Minerva Med 1981; 72:3097-9. [PMID: 7029354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Authors have studied the incidence of septic complications due to subclavian vein catheterization, According to literature, have considered that this is generally connected to the operating ability. Septic contamination, though of high incidence, only exceptionally is reason of a septic clinical condition.
Collapse
|
50
|
Morino F, Balzola F, Robecchi A, Domeniconi D, Serra GC, Boggio Bertinet D, Patria S, Cattaneo U, Fronda GR. [Personal experience in jejunoileal bypass for the treatment of obesity]. Minerva Dietol Gastroenterol 1980; 26:263-70. [PMID: 7219777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
|